Educated nurses boon to patients

Experts estimate that between 40,000 and 100,000 patients die each year as a result of medical errors. According to Sean P. Clarke, associate director of the University of Pennsylvania’s Center for Health Outcomes and Policy Research, recruiting and retaining highly educated nurses might be the biggest key to reducing that figure and improving patient safety.

“Hospitals that recruit and retain nurses with baccalaureate degrees are different, and that makes a difference in patient care,” says Clarke, who was the featured speaker for the School of Nursing’s fourth annual Littlefield Lecture series on Sept. 26. The series is named for former School of Nursing Dean Vivian Littlefield, a legendary proponent of nursing leadership.

During a 19-month period, center researchers studied surgical patient outcomes for more than 232,000 patients at 168 Pennsylvania hospitals. Results showed that nurse education levels and patient outcomes appear to be directly related: Hospitals in which less than 20 percent of nurses held baccalaureate degrees experienced an average of three additional patient deaths. In hospitals in which more than half of the nurses were baccalaureate-trained, there were three fewer deaths.

“These are results that tell us education matters at a certain level in creating a patient environment focused on safety,” says Clarke, who spoke to nursing students and nurse-researchers, and covered the particulars of several center studies, including one featured in an early September edition of the Journal of the American Medical Association.

Clarke’s solution to improve the patient-care environment is to focus on the root causes that lead to patient deaths in situations in which actions by nurses and doctors fail to help. He contends that hospital leadership is a key influence in shaping that environment, and can work to improve nursing salaries, staffing ratios, surveillance techniques and, most important, recruiting and retention of highly educated and trained nurses.

Clarke’s research indicates that when the patient-to-nurse ratio is reduced by even one, more patients are likely to die. Nurses in understaffed environments are also more likely to suffer needle-stick injuries.

“The deal is that patients have the right to be comfortable in the health-care environment,” Clarke notes. “They don’t need to be worrying about safety issues. Patients expect to come to a hospital to get better, not worse. If we cannot keep that contract, we face sad prospects.”